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Modulation of Prefrontal Function Through Transcranial Direct Current Stimulation (tDCS)
Abstracts / Brain Stimulation 10 (2017) e21ee45
Results
Abstract
Following 9 days of 18HZ and 3 days of iTBS her depression remitted (BDI 25/12, CGI-S 7/2) and treatments were decreased to twice a week. OCD symptoms and anxiety remained unchanged.
Introduction
Conclusions iTBS with the H1 coil shows promise as an alternative treatment protocol for the treatment of depression in general, particularly in patients with high MTs.
Disclosure Aron Tendler has a financial interest in Brainsway, the manufacturer of the H coils. Abstract #58 MODULATION OF PREFRONTAL FUNCTION THROUGH TRANSCRANIAL DIRECT CURRENT STIMULATION (TDCS) Christine Conelea 2, 3, Brittney Nicole C.R. McLaughlin*1, 2, 1 1, 2 Blanchette , Benjamin D. Greenberg , Timothy Mariano 4, 5. 1 Butler Hospital, Providence, RI, USA; 2 Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA; 3 Bradley Hospital, East Providence, RI, USA; 4 Department of Psychiatry, Brigham and Women’s Hospital, Boston, MA, USA; 5 Harvard Medical School, Boston, MA, USA
Abstract As part of a study testing if tDCS to the dorsal anterior cingulate cortex (dACC) would modulate affective responses to an acutely painful stimulus, cognitive tasks sensitive to the dACC and associated networks were administered. The Go/No-Go task is sensitive to response conflict and inhibitory control associated with dACC function. We studied 59 healthy adults randomized to anodal or cathodal stimulation targeting either left dACC (FC1 per the 10-20 EEG system; n¼10 anodal, n¼9 cathodal) or left dorsolateral prefrontal cortex (DLPFC; F3; n¼20 anodal, n¼20 cathodal), which was used as a control condition. The Go/No-Go task was completed a mean of 8 minutes after 20 minutes of 2mA tDCS. Two independent samples t-tests were carried out to compare anodal vs. cathodal stimulation at each target. Targeting DLPFC, there was a trend toward more omissions on the ‘go’ trials for cathodal vs anodal tDCS (p¼0.11), though there were no significant differences for mean ‘go’ reaction time (p¼0.65), ‘no-go’ commission errors (p¼0.50), and ‘no-go’ reaction time (p¼0.31). While we had predicted that tDCS targeting dACC might affect performance, there were no differences in Go/No-Go performance (mean ‘go’ omissions p¼0.61; ‘go’ reaction time p¼0.66; ‘no-go’ commissions p¼0.60; ‘no-go’ reaction time p¼0.65) when anodal and cathodal tDCS were compared. Understanding the optimal stimulation parameters for altering prefrontal functioning may lead to possible treatment options for a variety of clinical disorders. Abstract #59 DECREASED SNACK FOOD INTAKE IN OBESITY FOLLOWING NONINVASIVE NEUROMODULATION TARGETED TO THE LEFT DORSOLATERAL PREFRONTAL CORTEX (LDLPFC) Marci E. Gluck*1, Sascha Heinitz 1, Miguel Alonso-Alonso 2, Eric M. Wassermann 3, Colleen A. Venti 1, Susanne B. Votruba 1, Jonathan Krakoff 1. 1 Phoenix Epidemiology and Clinical Research Branch, National Institutes of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, AZ, USA; 2 Laboratory of Bariatric and Nutritional Neuroscience, Center for the Study of Nutrition Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; 3 Behavioral Neurology Unit, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
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Obesity is associated with lower post-meal activation in the prefrontal cortex. Transcranial direct current stimulation (tDCS) modifies cortical excitability and may facilitate improved control of eating. We measured energy intake (EI) and body weight in subjects receiving anodal vs. sham tDCS aimed at the LDLPFC.
Methods Twenty (13M) healthy volunteers with obesity (110±21kg [M±SD]; 34±1y) were admitted as inpatients for 11 days. Following 5d of a weight-maintaining diet, volunteers participated in a taste test and instructed to consume as much/little as they wanted of 4 common snack foods, weighed before after. Volunteers were randomized to receive anodal (2mA, 40min) or sham tDCS on the next 3 consecutive mornings and then ate ad libitum from a computerized vending machine, which recorded EI. Weight was measured daily. After discharge, they continued in a 4-week outpatient study, receiving tDCS on 3 mornings/wk. On the last day of the study, the taste test was repeated.
Results There were no differences in EI on the vending machines or weight change between the sham vs. active group during the inpatient study. However, after 4-weeks, the active stimulation group ate significantly less (-38±42 kcal) during the follow-up taste test compared to sham (64±119 kcal; t ¼ 2.7, p ¼ 0.02), despite no differences in weight change.
Discussion and Conclusion These results indicate a role for the LDLPFC in obesity. This is one of the first studies demonstrating an effect of longer term tDCS on EI in individuals with obesity. Abstract #60 TOWARD AN OPTOGENETIC MODEL OF VENTRAL CAPSULE/VENTRAL STRIATUM (VC/VS) DEEP BRAIN STIMULATION (DBS) David Rosenthal*, Baila Hall, Adam Kenet, Robert Fetcho, Thu Huynh Ph.D., Mitchell Murdock, Timothy Spellman Ph.D., Jonathan Wiztum, Conor Liston M.D., Ph.D.. Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY, USA
Abstract Deep brain stimulation (DBS) is a neurosurgical intervention FDAapproved for Parkinson’s disease and essential tremor, which shows promise as an intervention in psychiatric disorders such as major depression and obsessive-compulsive disorder. The mechanisms underlying DBS remain poorly understood. Advances in systems neuroscience, however, provide opportunities to study DBS mechanisms through new tools for systematically activating, inhibiting, and recording from particular neuronal subtypes. Projection-specific, high-frequency optogenetic stimulation has been previously employed to interrogate neuronal populations purportedly targeted by deep brain stimulation in a hemiParkinsonian rodent model. Here, we extend the logic of this work to investigate the neural underpinnings of the behavioral effects of ventral capsule/ventral striatal (VC/VS) DBS. VC/VS DBS, which has received an FDA humanitarian device exemption (HDE) for OCD, and has been investigated as a treatment for major depression, is known to induce acute, reversible, and parameter-dependent hedonic effects, including laughter, smiling, and hypomania. This exploratory pilot study tested the effects of high-frequency optogenetic stimulation of two populations of nucleus accumbens-projecting cortical neurons in mice, employing assays of depression- and anxiety-related behaviors, with the intention of modeling
Results
Abstract
Following 9 days of 18HZ and 3 days of iTBS her depression remitted (BDI 25/12, CGI-S 7/2) and treatments were decreased to twice a week. OCD symptoms and anxiety remained unchanged.
Introduction
Conclusions iTBS with the H1 coil shows promise as an alternative treatment protocol for the treatment of depression in general, particularly in patients with high MTs.
Disclosure Aron Tendler has a financial interest in Brainsway, the manufacturer of the H coils. Abstract #58 MODULATION OF PREFRONTAL FUNCTION THROUGH TRANSCRANIAL DIRECT CURRENT STIMULATION (TDCS) Christine Conelea 2, 3, Brittney Nicole C.R. McLaughlin*1, 2, 1 1, 2 Blanchette , Benjamin D. Greenberg , Timothy Mariano 4, 5. 1 Butler Hospital, Providence, RI, USA; 2 Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA; 3 Bradley Hospital, East Providence, RI, USA; 4 Department of Psychiatry, Brigham and Women’s Hospital, Boston, MA, USA; 5 Harvard Medical School, Boston, MA, USA
Abstract As part of a study testing if tDCS to the dorsal anterior cingulate cortex (dACC) would modulate affective responses to an acutely painful stimulus, cognitive tasks sensitive to the dACC and associated networks were administered. The Go/No-Go task is sensitive to response conflict and inhibitory control associated with dACC function. We studied 59 healthy adults randomized to anodal or cathodal stimulation targeting either left dACC (FC1 per the 10-20 EEG system; n¼10 anodal, n¼9 cathodal) or left dorsolateral prefrontal cortex (DLPFC; F3; n¼20 anodal, n¼20 cathodal), which was used as a control condition. The Go/No-Go task was completed a mean of 8 minutes after 20 minutes of 2mA tDCS. Two independent samples t-tests were carried out to compare anodal vs. cathodal stimulation at each target. Targeting DLPFC, there was a trend toward more omissions on the ‘go’ trials for cathodal vs anodal tDCS (p¼0.11), though there were no significant differences for mean ‘go’ reaction time (p¼0.65), ‘no-go’ commission errors (p¼0.50), and ‘no-go’ reaction time (p¼0.31). While we had predicted that tDCS targeting dACC might affect performance, there were no differences in Go/No-Go performance (mean ‘go’ omissions p¼0.61; ‘go’ reaction time p¼0.66; ‘no-go’ commissions p¼0.60; ‘no-go’ reaction time p¼0.65) when anodal and cathodal tDCS were compared. Understanding the optimal stimulation parameters for altering prefrontal functioning may lead to possible treatment options for a variety of clinical disorders. Abstract #59 DECREASED SNACK FOOD INTAKE IN OBESITY FOLLOWING NONINVASIVE NEUROMODULATION TARGETED TO THE LEFT DORSOLATERAL PREFRONTAL CORTEX (LDLPFC) Marci E. Gluck*1, Sascha Heinitz 1, Miguel Alonso-Alonso 2, Eric M. Wassermann 3, Colleen A. Venti 1, Susanne B. Votruba 1, Jonathan Krakoff 1. 1 Phoenix Epidemiology and Clinical Research Branch, National Institutes of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, AZ, USA; 2 Laboratory of Bariatric and Nutritional Neuroscience, Center for the Study of Nutrition Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; 3 Behavioral Neurology Unit, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
e37
Obesity is associated with lower post-meal activation in the prefrontal cortex. Transcranial direct current stimulation (tDCS) modifies cortical excitability and may facilitate improved control of eating. We measured energy intake (EI) and body weight in subjects receiving anodal vs. sham tDCS aimed at the LDLPFC.
Methods Twenty (13M) healthy volunteers with obesity (110±21kg [M±SD]; 34±1y) were admitted as inpatients for 11 days. Following 5d of a weight-maintaining diet, volunteers participated in a taste test and instructed to consume as much/little as they wanted of 4 common snack foods, weighed before after. Volunteers were randomized to receive anodal (2mA, 40min) or sham tDCS on the next 3 consecutive mornings and then ate ad libitum from a computerized vending machine, which recorded EI. Weight was measured daily. After discharge, they continued in a 4-week outpatient study, receiving tDCS on 3 mornings/wk. On the last day of the study, the taste test was repeated.
Results There were no differences in EI on the vending machines or weight change between the sham vs. active group during the inpatient study. However, after 4-weeks, the active stimulation group ate significantly less (-38±42 kcal) during the follow-up taste test compared to sham (64±119 kcal; t ¼ 2.7, p ¼ 0.02), despite no differences in weight change.
Discussion and Conclusion These results indicate a role for the LDLPFC in obesity. This is one of the first studies demonstrating an effect of longer term tDCS on EI in individuals with obesity. Abstract #60 TOWARD AN OPTOGENETIC MODEL OF VENTRAL CAPSULE/VENTRAL STRIATUM (VC/VS) DEEP BRAIN STIMULATION (DBS) David Rosenthal*, Baila Hall, Adam Kenet, Robert Fetcho, Thu Huynh Ph.D., Mitchell Murdock, Timothy Spellman Ph.D., Jonathan Wiztum, Conor Liston M.D., Ph.D.. Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY, USA
Abstract Deep brain stimulation (DBS) is a neurosurgical intervention FDAapproved for Parkinson’s disease and essential tremor, which shows promise as an intervention in psychiatric disorders such as major depression and obsessive-compulsive disorder. The mechanisms underlying DBS remain poorly understood. Advances in systems neuroscience, however, provide opportunities to study DBS mechanisms through new tools for systematically activating, inhibiting, and recording from particular neuronal subtypes. Projection-specific, high-frequency optogenetic stimulation has been previously employed to interrogate neuronal populations purportedly targeted by deep brain stimulation in a hemiParkinsonian rodent model. Here, we extend the logic of this work to investigate the neural underpinnings of the behavioral effects of ventral capsule/ventral striatal (VC/VS) DBS. VC/VS DBS, which has received an FDA humanitarian device exemption (HDE) for OCD, and has been investigated as a treatment for major depression, is known to induce acute, reversible, and parameter-dependent hedonic effects, including laughter, smiling, and hypomania. This exploratory pilot study tested the effects of high-frequency optogenetic stimulation of two populations of nucleus accumbens-projecting cortical neurons in mice, employing assays of depression- and anxiety-related behaviors, with the intention of modeling